Inflammation is associated with many inner ear disorders of unknown etiology. It is believed that otitis media (OM)-associated inner ear inflammation results in high frequency sensorineural hearing loss (SNHL) in as high as 3% of OM patients. Moreover, the incidence can be underestimated because ultrahigh-frequency SNHL and transient hearing threshold shifts are hard to detect with routine hearing tests. However, it is not well known which type of inner ear cells involved in inner ear inflammation by recognizing bacterial molecules and recruiting inflammatory cells. The spiral ligament fibrocytes (SLFs) produce inflammatory mediators such as MCP1, attracting monocytes. Monocytes predominantly infiltrate cochlea with chronic OM or acoustic trauma. This makes MCP1 the ideal SLF-derived chemokine, attracting effector cells and causing inner ear damage. Nontypeable Haemophilus influenzae (NTHI) is the model organism for inducing inner ear inflammation, which is one of the major OM pathogens. Interestingly, toll-like receptor 2 (TLR2) plays a significant role in recognizing NTHI molecules in the epithelial cells even though it is a Gram-negative bacterium. We hypothesize that SLFs recognize NTHI molecules and release MCP1 through TLR2-dependent NF?B activation. Furthermore, we hypothesize that NTHI-induced MCP1 up-regulation is involved in inner ear inflammation secondary to OM, resulting in SNHL. We therefore propose the following three Specific Aims to test our hypotheses:; 1. Do SLFs release MCP1 upon recognition of NTHI through the TLR2-dependent signaling pathway? We will determine TLR2 expression in the cochlea and involvement of the TLR2-MyD88 signaling pathway in recognizing NTHI molecules by SLFs in both in vitro and in vivo models. 2. Does NTHI-induced MCP1 up-regulation require NF?B activation mediated by I?K[unreadable]-dependent I?Ba phosphorylation? We will investigate the involvement of I?K[unreadable]-dependent I?Ba phosphorylation in NTHI-induced MCP1 up- regulation and identify the specific NF?B subunits and binding sites that are responsive to NTHI. 3. Does the blockage of NTHI-induced MCP1 up-regulation prevent inner ear inflammation secondary to OM We will determine if the presence of NTHI lysate and MCP1 in the middle ear cavity cause inner ear inflammation, resulting in SNHL and explore the possibility of blocking TLR2 and depleting MCP1 to inhibit NTHI-induced SNHL. We believe that this project can shed light on the molecular pathogenesis of inner ear complications secondary to OM. Furthermore, the findings will facilitate future development of novel therapeutic strategies to prevent potential inner ear complications of OM. The goal of this project is to study how middle ear infection affects the inner ear. We aim to investigate the molecular pathogenesis related to bacterial recognition in the inner ear, inner ear inflammation, inner ear damage and hearing loss.